How much rates vary
Facilitymedian $162 · 10th to 90th $100 to $355Professionalmedian $158 · 10th to 90th $74 to $251
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $309.03 | Professional | None | $144.54 | $158.49 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $186.21 Typical High $269.15 | Facility | None | $162.18 | $186.21 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $208.93 | Professional | None | $95.50 | $162.18 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $331.13 Typical High $676.08 | Facility | None | $100.00 | $331.13 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $109.65 Typical High $309.03 | Professional | None | $72.44 | $109.65 | $309.03 |
DeanCare Setting Facility Modifier None Typical Low $51.29 Median $158.49 Typical High $181.97 | Facility | None | $51.29 | $158.49 | $181.97 |
DeanCare Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $269.15 | Professional | None | $173.78 | $257.04 | $269.15 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $158.49 Typical High $831.76 | Facility | None | $81.28 | $158.49 | $831.76 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $117.49 Typical High $1,174.90 | Professional | None | $74.13 | $117.49 | $1,174.90 |
Network Health Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Network Health Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $281.84 | Professional | None | $114.82 | $151.36 | $281.84 |
Prevea360 Setting Facility Modifier None Typical Low $51.29 Median $158.49 Typical High $181.97 | Facility | None | $51.29 | $158.49 | $181.97 |
Prevea360 Setting Professional Modifier None Typical Low $91.20 Median $158.49 Typical High $213.80 | Professional | None | $91.20 | $158.49 | $213.80 |
Quartz Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $407.38 | Professional | None | $162.18 | $245.47 | $407.38 |
Quartz Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $107.15 | Facility | None | $100.00 | $100.00 | $107.15 |
Quartz Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
United Setting Facility Modifier None Typical Low $102.33 Median $107.15 Typical High $263.03 | Facility | None | $102.33 | $107.15 | $263.03 |
United Setting Professional Modifier None Typical Low $66.07 Median $107.15 Typical High $141.25 | Professional | None | $66.07 | $107.15 | $141.25 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $162.18 | Professional | 52 · Reduced service | $79.43 | $79.43 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $64.57 | Professional | 53 · Discontinued | $31.62 | $31.62 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $48.98 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $32.36 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $32.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.55 Median $9.55 Typical High $12.59 | Professional | RR · Rental | $9.55 | $9.55 | $12.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $72.44 Median $72.44 Typical High $77.62 | Professional | UE · Used equipment | $72.44 | $72.44 | $77.62 |
Where Wisconsin sits
The same service costs 4.1 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Wisconsin· 12th of 51
$158
HI $295DE $72.44
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.